患者71岁，男性，反复活动后胸闷、气促半年余入院。超声心动图提示二尖瓣、三尖瓣重度反流。患者1983年曾行体外循环下房间隔缺损修补术，2010年曾因肾功能衰竭行右肾移植术。2019年对该患者实施了二尖瓣和三尖瓣生物瓣置换，患者安全度过围术期，未发生明显感染及急性肾功能不全，且复查超声心动图人工二尖瓣、三尖瓣未见异常，最终顺利出院。对肾移植患者行体外循环心脏手术的报道较少，二次体外循环手术更为少见。该病例的临床资料及围术期的处理方法可为其他术者提供借鉴。

A 71-year-old man was admitted to hospital due to chest tightness and shortness of breath for more than half a year. Echocardiography suggested severe mitral regurgitation and tricuspid regurgitation. The patient underwent repair of atrial septal defect under cardiopulmonary bypass in 1983 and right kidney transplantation in 2010 due to renal failure. Mitral and tricuspid biovalve replacement was performed on the patient in 2019. No obvious infection and acute renal insufficiency occurred after the operation, and no abnormality was found in the artificial mitral valve and tricuspid valve on echocardiography. The patient was discharged successfully. There are few reports of cardiopulmonary bypass for renal transplant patients, especially for the second time. This case and perioperative management can provide reference for other surgeons.